It can be found in the nose, pharynx throat , larynx voice box , trachea windpipe , esophagus swallowing tube and the lungs. While the child is awake, a small flexible telescope is passed through the nose and throat to look for RRP in the upper airway, to the level of the vocal cords.
If RRP is in the upper airway, it can be seen with this scope. A microscopic laryngoscopy and bronchoscopy MLB may need to be done to look at the airway below the level of the vocal cords in addition to the voice box.
This is done in the operating room with the child under a general anesthetic. The goal of treatment for RRP is keeping the airway safe. This is done by repeated removal of RRP. In a small number of children with very severe disease, a tracheotomy may be needed to maintain a safe airway.
This is quite rare, however. Many surgical treatments exist for removing RRP. Lasers are able to destroy the RRP tissue. Mechanical shavers microdebriders allow RRP to be suctioned and cut free from the nearby tissue with great accuracy.
The papillomas may vary in size and grow very quickly. They often grow back after they have been removed. There are more than types of HPV, and they do not all have the same symptoms. Most people who encounter HPV never develop a related illness. However, in a small number of people exposed to the HPV 6 or 11 virus, respiratory tract papillomas and genital warts can form.
Although scientists do not fully understand why some people develop the disease and others do not, the virus is thought to be spread through sexual contact or when a mother with genital warts passes the HPV 6 or 11 virus to her baby during childbirth. RRP may occur in adults adult-onset RRP as well as in infants and small children juvenile-onset RRP who may have contracted the virus during childbirth. According to the Centers for Disease Control and Prevention CDC , estimates of the incidence for juvenile-onset RRP are imprecise but range from two or fewer cases per , children under age Even less is known about the incidence of the adult form of RRP.
Estimates of the incidence for adult-onset RPP range between two to three cases per , adults in the U. Normally, the human voice is produced when air from the lungs is pushed through two side-by-side specialized muscles—called vocal folds —with enough pressure to cause them to vibrate see illustration. Hoarseness, the most common RRP symptom, is caused when RRP papillomas interfere with the normal vibrations of the vocal folds.
Eventually, RRP tumors may block the airway passage and cause difficulty breathing. RRP symptoms tend to be more severe in children than in adults.
Because the tumors grow quickly, young children with the disease may find it difficult to breathe when sleeping, or they may have difficulty swallowing. Some children experience some relief or remission of the disease when they begin puberty.
Both children and adults may experience hoarseness, chronic coughing, or breathing problems. Because of the similarity of the symptoms, RRP is sometimes misdiagnosed as asthma or chronic bronchitis. Health professionals use two routine tests for RRP: indirect and direct laryngoscopy. Some medical professionals use a video camera attached to this endoscope to view and record the exam. An older, less common method is for the otolaryngologist to place a small mirror in the back of the throat and angle the mirror down toward the larynx to inspect it for papillomas.
Sometimes, shortness of breath and noisy breathing are mistaken for asthma or croup. Thus, children may occasionally be treated for asthma and croup without any improvement in their breathing difficulties. Patients with papillomas that are partially blocking the airway and causing shortness of breath and noisy breathing should consult with a physician immediately to determine whether emergency surgery to remove the papillomas is indicated. All use of this site indicates acceptance of our Terms of Service.
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